Provider Demographics
NPI:1942503016
Name:INNOVATIVE ORTHOPEDIC MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:INNOVATIVE ORTHOPEDIC MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCHLOMO
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:818-304-0702
Mailing Address - Street 1:PO BOX 26268
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-0577
Mailing Address - Country:US
Mailing Address - Phone:818-304-0702
Mailing Address - Fax:213-799-3040
Practice Address - Street 1:2709 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-2101
Practice Address - Country:US
Practice Address - Phone:818-304-0702
Practice Address - Fax:213-799-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies